Tag: audit

OIG focuses on life expectancy in latest hospice audit

The Department of Health and Human Services Office of Inspector General (OIG) has suggested a hospice provider in Fairfield, Calif., repay $3.3 million to Medicare after its latest audit. The report, released earlier this month, alleged 21 of the 100 sampled claims over a two-year period did not support the associated beneficiary’s terminal prognosis. “Specifically, […]

Latest OIG audit suggests case-mix reductions a red flag for claim reviews

The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently announced the results of an audit of Brookdale Home Health. The report came a familiar focus on ambulation, homebound and medical necessity. But there was another important note in the report that puts a fresh emphasis on case mix. The review […]

SNFs, Therapy Contracts and Fraud: Redux by Reg Hislop III

Yes another SNF, another therapy contract and more fraud settlements.  The only thing that isn’t different is the contractor – RehabCare once again (a coincidence?…not likely). In news released late last week, a Maine SNF settled with the Department of Justice for $1.2 million, allegations of improper Medicare billings for “unnecessary, inflated, and unreasonable” therapy […]